COVID-19 Update from Dr. Smith: 4/27/20

Each day during the COVID-19 crisis, Dr. Craig Smith, Chair of the Department of Surgery, sends an update to faculty and staff about pandemic response and priorities. Stay up to date with us.

Dear Colleagues,

Restart is the universal word of the month, and of the next several months.  Among the issues most critical to this Department is the resumption of scheduled operations.  Last week our Division Chiefs worked at warp speed to prioritize previously postponed and new patients based on clinical urgency and expected resource utilization.  The three urgency levels correspond approximately to May, June, and July or beyond.  OR capacity is expanding slightly this week, then more rapidly over the next two weeks.  That will give the screening system currently in place the ability to schedule progressively less urgent cases, and begin reducing the backlog of March-April cancellations.  The pace for outpatient procedures should expand dramatically once the David H. Koch Center (DHK) can repatriate enough staff to run it, hopefully within 2-3 weeks.  DHK is expected to be the site for all outpatient procedures indefinitely, including all CU patients.  NYP hopes to staff DHK 7 days/week, possibly 24 hours/day.  A date after which we can resume truly elective scheduling has not been determined.  My guess is June 1 or later, and that date may be earlier for outpatient procedures than inpatient procedures.  Elective procedures requiring an ICU stay will be difficult to schedule until our ICUs decompress.

In healthcare, “rebalance” might be a better word than “restart.”  We are adjusting priorities, and looking forward to providing care more broadly, in better alignment with our specific training and interests.  While ICU care was flying off the shelves we radically restocked but never had to close the store.  Most of us retained the inestimable luxury of feeling useful.  “Restart” applies more literally to the rest of the world we live in.  Their stop was sixty to zero.  Some went through the windshield.  In two months the most widespread prosperity in the history of humankind has been replaced with isolation, house arrest, job loss, and fear of bankruptcy.  The desire to restart business is passionate and desperate and completely rational.  On my drive home I heard a snippet from a Governor Cuomo press conference today describing the preconditions for restarting businesses, including requirements to maintain social distancing, cleaning, testing, appropriate PPE…

Houston, we have a problem.  Factories, offices, stores, and entertainment facilities will be reopening over approximately the same period of time that we’re reopening all of our outpatient offices, clinics, and operating rooms, and figuring out how to safely welcome visitors again.  Competition for supplies of PPE, cleaning products, hand sanitizer, gloves, and everything else that businesses will be consuming may return us to a posture of conservation we thought we’d left behind.  That may not be a bad thing.  A very important part of the “new” in new-normal is finding a realistic middle ground between unnecessary risk and excessive caution.  That balance is an important step on the road back to a new normal that eventually includes handshakes, hugs, and unmasked smiles.

Craig R. Smith, MD
Chair, Department of Surgery
Surgeon-in-Chief, NYP/CUIMC

Get Dr. Smith's COVID-19 updates in your inbox.

Note: this message was edited on 05/01/20 to correct the name of the outpatient center. It is the David H. Koch Center, not the Donald H. Koch Center.